Neurosurgery
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Preservation of facial nerve function following vestibular schwannoma surgery is a high priority. Even those patients with normal to near-normal function in the early postoperative period remain at risk for delayed facial palsy (DFP). ⋯ CI, confidence intervalDFP, delayed facial palsyGTR, gross total resectionHB, House-BrackmannNFP, no facial palsyOR, odds ratioRS, retrosigmoidTL, translabyrinthineVS, vestibular schwannoma.
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The blood-brain barrier represents a fundamental limitation in treating neurological disease because it prevents all neuropeptides from reaching the central nervous system (CNS). Currently, there is no efficient method to permanently bypass the blood-brain barrier. ⋯ ANOVA, analysis of varianceBBB, blood-brain barrierDLS, dorsal lateral striatumGDNF, glial cell line-derived neurotrophic factorPBS, phosphate-buffered salinePD, Parkinson disease6-OHDA, 6-hydroxydopamineSNpc, substantia nigra pars compactaTH, tyrosine hydroxylase.
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Case Reports
A Perforating Artery Compressing the Nerve Rootlet and Causing Glossopharyngeal Neuralgia.
A surgical procedure for glossopharyngeal neuralgia (GPN) was selected from microvascular decompression, glossopharyngeal and upper vagal rhizotomy, or a combination of these procedures based on the presence of arteries compressing the glossopharyngeal and vagal rootlets. The offending artery is usually a main trunk or branch of the cerebellar arteries. A perforating artery is a known but uncommon variation of the offending artery that causes GPN. The appropriate procedure for such cases is unknown. ⋯ Even a small perforating artery can cause GPN when it compresses the rootlet. In such cases, mobilization of the perforating artery with no additional rhizotomy is an effective surgical option.
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The 10th cranial nerve (CN X) is at risk during surgery in the lower cerebellopontine angle (CPA). ⋯ Endotracheal surface electrodes allow identification of vocal cord motor rootlets in the CPA. Worsening of CMAP parameters might indicate functional impairment. These aspects support the use of endotracheal surface electrodes in selected patients in whom the vagus nerve might be at risk during CPA surgery.